LECTURES DELIVERED AT THE LOCK HOSPITAL, LONDON
Authors: H. Lee
Journal: BMJ (1854)

OWJNAL COMKUNIOATIONS.and that every phas of growth has its forms of C i (Note, No. IT, p. 169.)And if in natural or oZiinal growth we find monstrosities and defects-arrests of development and excesses-exubernce and deficiency; so, afortion., analogous deviations may be expected in pre- 4ernatural inflammatory growth." If injured textures are repaired and wounds heal, inj&ammation is Aeallhy; if gra- nulations persist and will not heal, in,flammatuon is un- Aaisky; and if normal textures continue to yield, giving way to inflammatory growtbhs, scrofuloia disease is esta- MiaId."*The general conclusion which arises from the establish- ment of the foregoing propositions, may be expressed as follows.Vascular tissue, upon injury or irritation, recedes from its established or completed form to some anterior type of growth.Blood vessels yield in structure; upon which follow effusion of lymph, and the formation of new vessels sustaining new growth.To this phenomenon the term in- flammation is applied.The products or results are extremely various: repair of injury, elimination of morbid matter ifrom the blood, pustules, abscess, ulceration, and scrofulous disees." As to what may be the essence of small pox, I am, for my own part, free to confess that I am wholly ignorant.Nevertheless, when I carefully weigh the evidence of the Lsymptoms, it suggests to me the idea of inflammation.In clearing herself of this, nature is at work during the first -two or three days, striving at the digestion and concoctiont -of the inflamed particles, with the intention of afterwards discharging them upon the surface of the body, for the sake ,of maturation, and finally of expelling them from her boundaries under the form of little abscesses."We must, then, if we wish to make our methoduas me- .dendi the superstructure to a foundation in principles, recognise two periods in this disease: first, the period of .separation;secondly, the period of expulsion."' The first of these two periods is generally passed in a febrile ebullition, which usually is completed within the first three or four days.Du,ing this stage nature i8 em- .pyedupon picking out and7 athering toyether those inflamed elimen8 which fret the blood, in making them over to the fleshy parts of the body, and in depositing them therein.This being accomplished, she returns to her former repose, Javing allayed the tumult which was excited during her operations in the blood." When the ebullition has thus brought about the sepa- :ration, the process of expulsion begins, and this continues From the 4th to the 22nd of Augu twty nocul wer made with well chosen pus Six little pustule 2 sulted, which were healed in five or six dayS.This patient was kept in the hospital until the 13th d September, when she was allowed to depart, after having remained in the hospital for four months and four days, and been inoculated eighty-nine times.No constitutional symptoms, it is said, showed themsels in this case, and the patient left in perfect health.Six cicatrices on the hypochondriac regions were the mt visible; the others, although numnerous enough, were small: they all were gradually becoming fainLer.This patiest was considered almost syphilised.CAsE it.A. B., aged 16, was admitted into the S ilicome on the ist of Auguist, 1851, affected with a primy syphilitic ulceration on the anterior lip of the neck of the womb.There had been no previous dLsease.August 3rd.The pus from the ulcer on the neck of the womb was inoculated in two places on the right hypochndriac region.August 4th.The points where the pus was insted were slightly red.August 5th.A little vesicle had appeared upon each.August 6th.The syphilitic pustule had appeared at the two points; there was some fever.August 7th.The fever had increased; the pustules broke, and exposed primary syphilitic ulcerations; the base of these began to feel slightly indurated.August 8th.The pus from the last named pustuleslwas inoculated on the corresponding point on the left side in two places.August 11th.Two pustules had appeared in the situation of the last inoculations.The two first artificial ulcer- ations continued to increase; they were indurated, and presented all the characteristics of the Hunterian chancre.August 13th.The pustules arising from the inoculations made on the 8th had been open for the last two days; the sores left were smaller, less inflamed, less hard, and lees painful than the first.August 15th.Seven inoculations were made, with the pus from the first artificial sores, under the right breast.August 18th.Seven little pustules had resulted from